实时剪切波弹性成像技术在儿童慢性肾脏病中的诊断价值。

Diagnostic value of real-time shear wave elastography in children with chronic kidney disease.

机构信息

Ultrasound Department, Affiliated Children's Hospital, Capital Institute of Pediatrics, Beijing, China.

出版信息

Clin Hemorheol Microcirc. 2021;77(3):287-293. doi: 10.3233/CH-200982.

DOI:10.3233/CH-200982

PMID:33337353

Abstract

OBJECTIVE

To evaluate the diagnostic value of real-time shear wave elastography (SWE) in children with chronic kidney disease (CKD).

METHODS

Children with CKD diagnosed by the ultrasound-guided biopsy between January 2018 and May 2019 were enrolled as the case group. Age- and sex- matched healthy children were selected as the control group. The Young's Modulus (YM) of the renal cortex was measured by SWE after the traditional ultrasound examination. Variance analysis was performed to compare the values of YM between the two groups. Receiver operating characteristic curve (ROC) analysis was used to compare the values of YM, and explore the cut-offs of the YM.

RESULTS

In the case group (n = 60, 45% male, mean age of 9.2 years), the kidney YM modulus on the left side (16.8±4.8 kPa vs. 8.3±2.1 kPa) and the right side (16.0±4.7 kPa vs. 8.3±2.4 kPa) were both higher than the control group (all P values < 0.001). With the progress of CKD, the YM value of the left and right kidneys gradually increased. ROC analysis showed that when the left and right kidney YM value was 11.7 kPa and 11.0 kPa, the diagnostic sensitivity and specificity were the highest (left: respectively 93.3% and 95.0%; right: respectively 93.3 % and 91.7%).

CONCLUSION

The increase of YM in CKD is related to the progression of renal dysfunction which may provide a new method for early diagnosis of CKD, dynamic monitoring of disease progression, and evaluation of curative effect and prognosis.

摘要

目的

评价实时剪切波弹性成像（SWE）在儿童慢性肾脏病（CKD）中的诊断价值。

方法

纳入 2018 年 1 月至 2019 年 5 月经超声引导肾活检诊断为 CKD 的患儿为病例组，选择同期健康体检儿童为对照组。常规超声检查后行 SWE 测量肾皮质杨氏模量（YM），比较两组间 YM 值的差异。采用受试者工作特征曲线（ROC）分析比较 YM 值的诊断效能，并探讨 YM 的截断值。

结果

病例组（n=60，男 45%，平均年龄 9.2 岁）左、右侧肾脏 YM 值[（16.8±4.8）kPa 比（8.3±2.1）kPa 和（16.0±4.7）kPa 比（8.3±2.4）kPa]均高于对照组（均 P 值<0.001）。随着 CKD 的进展，左、右肾 YM 值逐渐增加。ROC 分析显示，左、右肾 YM 值分别为 11.7 kPa 和 11.0 kPa 时，诊断的灵敏度和特异度最高（左：分别为 93.3%和 95.0%；右：分别为 93.3%和 91.7%）。